VCBE Case of the Month

Caramel, a 5-year-old female spayed ferret, was first brought to the Veterinary Center a few weeks ago to be euthanized. Seven months prior, Caramel had been diagnosed with congestive heart failure at another hospital and was started on Lasix (a diuretic medication). Diuretics are a main category of medications used to treat heart failure, as they cause the patient to urinate more, therefore decreasing the amount of fluid in the bloodstream that the heart has to handle. Caramel had not been examined since the time the Lasix was started at the other animal hospital 7 months ago. Prior to seeing us, Caramel stopped eating and was losing weight. Her owner brought her in to see us since Caramel had become very weak and seemed to be having seizures. Her owner was worried that there was nothing more she could do and that she had to put her to sleep. Dr. Hess and Dr. Ravich performed a physical examination which showed that Caramel was emaciated, was breathing quickly, and had muffled heart sounds on the right side of her chest (indicating that she definitely had some type of lung disease).

X-rays were performed which showed an opaque structure in the entire left lung lobe, reducing the room for air in that lung. This structure could be secondary to infection like pneumonia, an abscess or cancer. Due to the opacity in the lung, it was impossible to see the outline of the heart, which is important when attempting to diagnose heart failure. The doctors ran blood tests that showed moderate elevations in the liver and kidney values. An echocardiogram (ultrasound of the heart) was scheduled for the following day so the doctors could evaluate Caramel for heart failure. The doctors sent Caramel home overnight with a syringe feeding formula so that her owner could syringe feed, her as she was not eating on her own.

The following day, Caramel came in for the echocardiogram that showed that Caramel had normal heart function and was not at all in heart failure; however, she was so dehydrated from being on the diuretic for so many months that her heart size was half of what it should be. Lasix, the diuretic, causes animals to urinate more and lose water. While this is the desired result if an animal is in heart failure and is retaining fluid in its lungs, since Caramel was not in heart failure, Lasix was stopped. Caramel was hospitalized overnight and given multiple doses of subcutaneous (under the skin) fluids to help hydrate her. She was also syringe fed, which she took willingly. In addition, as Dr. Hess and Dr. Ravich were suspicious about a lung infection, Caramel was started on a broad spectrum antibiotic.By the following morning, Caramel was more active. She was moving around, eating ferret kibble on her own, and passing normal stool. She was sent home on syringe feeding and the antibiotic.

Caramel came in for a follow up exam 10 days later. She was breathing normally and much more active. Caramel was also eating kibble eagerly on her own. The doctors instructed Caramel’s owner that the antibiotics should be continued for 1 more week, and then x-rays should be repeated. While we have not yet seen Caramel back for her progress examination, we are much encouraged by her progress. Everyone at the Veterinary Center has grown attached to, as she is clearly such as fighter, and we are all very happy that she was given a second chance.